Active NPI
Kateryna Kuzubova
- Mental Health Counselor
- Arlington, MA
National Provider Identifier
1316576325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C.1100356
- Practice address
- 339 Massachusetts Ave
Arlington, MA 02474-6718 - Phone
- (339) 368-7696
- NPI assigned
- Apr 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.1100356 | OH | Primary |
Addresses
Primary practice location
339 Massachusetts Ave
Arlington, MA 02474-6718
Mailing address
4 Aj Gordon CT Apt 104
S Hamilton, MA 01982-2347
Phone (351) 444-8735
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Arlington |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.1100356 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585785600000",
"number": "1316576325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 AJ GORDON CT APT 104",
"city": "S HAMILTON",
"state": "MA",
"postal_code": "019822347",
"telephone_number": "351-444-8735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 MASSACHUSETTS AVE",
"city": "ARLINGTON",
"state": "MA",
"postal_code": "024746718",
"telephone_number": "339-368-7696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUZUBOVA",
"first_name": "KATERYNA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-02",
"last_updated": "2020-04-02",
"certification_date": "2020-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C.1100356",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Arlington",
"affiliation": "N",
"address_1": "339 Massachusetts Ave",
"city": "Arlington",
"state": "MA",
"country_code": "US",
"postal_code": "024746718",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Arlington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.